Diagnosis of tuberculosis in South African children with a T cell-based assay: a prospective cohort study

S Liebeschuetz, S Bamber, K Ewer, Jonathan Deeks, A Pathan, A Lalvani

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    330 Citations (Scopus)

    Abstract

    BACKGROUND: Childhood tuberculosis often presents non-specifically and is a common differential diagnosis in high prevalence areas. Current diagnostic tools have poor sensitivity and cannot reliably exclude tuberculosis, so overdiagnosis is common. HIV co-infection exacerbates this problem and accounts for an increasing proportion of paediatric tuberculosis worldwide. METHODS: We assessed the usefulness of a T-cell-based rapid blood test for Mycobacterium tuberculosis infection, the enzyme-linked immunospot assay (ELISPOT), in routine clinical practice. We did a prospective blinded study of 293 African children with suspected tuberculosis in kwaZulu-Natal, a region with high HIV prevalence. Children had full clinical assessment, ELISPOT, and a tuberculin skin test. Test results were compared with final clinical and microbiological diagnoses. RESULTS: In children with tuberculosis, sensitivity of ELISPOT was 83% (95% CI 75-89, n=133), significantly higher (p
    Original languageEnglish
    Pages (from-to)2196-2203
    Number of pages8
    JournalLancet
    Volume364
    Issue number9452
    DOIs
    Publication statusPublished - 31 Dec 2004

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